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Abdominal Anatomy
Overview
Jennifer Green
General Imaging Training Manager
Applications Training for Service - Jennifer Green 2
• Scanning positions
• Sonographic anatomy
• System setup
ABDOMEN
Applications Training for Service - Jennifer Green 3
Ultrasound Scan Planes
• Sagittal
• Transverse
• Coronal
Applications Training for Service - Jennifer Green 4
Applications Training for Service - Jennifer Green 5
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Applications Training for Service - Jennifer Green 7
Ultrasound Terminology
• Anterior
• Medial
• Superior
• Supine
• Obli...
Applications Training for Service - Jennifer Green 8
Ultrasound Terminology
• Hyper echoic
• Echogenic
• Homogeneous
• Hyp...
Applications Training for Service - Jennifer Green 9
Anatomy
Applications Training for Service - Jennifer Green 10
Anatomy
• Liver
• Gall Bladder (GB)
• Common Bile
Duct (CBD)
• Pancr...
Applications Training for Service - Jennifer Green 11
GREAT VESSELS
• Aorta
• Celiac Axis
• SVC
• Renal Arteries
• Hepatic...
Applications Training for Service - Jennifer Green 18
LIVER
• Found in right upper quadrant (RUQ)
• Largest internal organ...
Applications Training for Service - Jennifer Green 19
LIVER
• During deep inspiration!!!,
• Patient position – supine
- le...
Applications Training for Service - Jennifer Green 21
Applications Training for Service - Jennifer Green 22
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GALL BLADDER(GB)
• Found in RUQ
• Contractile sack
• Contains and co...
Applications Training for Service - Jennifer Green 35
Applications Training for Service - Jennifer Green 36
Applications Training for Service - Jennifer Green 40
COMMON BILE DUCT (CBD)
• Conducts bile from the G.B. to the
duodenum...
Applications Training for Service - Jennifer Green 41
Applications Training for Service - Jennifer Green 42
PANCREAS
• Found in upper mid abdomen; extends
from the hilum of the...
Applications Training for Service - Jennifer Green 43
PANCREAS
• Best seen in supine position in inspiration
or pushed up ...
Applications Training for Service - Jennifer Green 44
Applications Training for Service - Jennifer Green 45
Applications Training for Service - Jennifer Green 46
KIDNEYS
• Paired organ; 9 –13cms long
• Principal parts: cortex, med...
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BLADDER
• It is a symmetrical, hollow, muscular organ.
• Located pos...
Applications Training for Service - Jennifer Green 57
BLADDER
• Function:
– Urine delivered through ureters, is
stored in ...
Applications Training for Service - Jennifer Green 58
Applications Training for Service - Jennifer Green 59
Applications Training for Service - Jennifer Green 60
PROSTATE
• Lies inferior to the urinary bladder,and anterior
to the ...
Applications Training for Service - Jennifer Green 61
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Applications Training for Service - Jennifer Green 63
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Applications Training for Service - Jennifer Green 67
UTERUS
• Pear shaped pelvic organ lying in midline.
• Found in the s...
Applications Training for Service - Jennifer Green 68
UTERUS
• Endometrial cavity is continuous with vagina via
cervix.
• ...
Applications Training for Service - Jennifer Green 69
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Applications Training for Service - Jennifer Green 71
OVARIES
• Paired pelvic organ, position very variable
alongside the ...
Applications Training for Service - Jennifer Green 72
Applications Training for Service - Jennifer Green 73
Applications Training for Service - Jennifer Green 74
Grey Scale
• U/S is a dynamic examination needing frequent
optimizat...
Applications Training for Service - Jennifer Green 75
Power and Gain
• Balance is needed to maintain safety
(ALARA princip...
Applications Training for Service - Jennifer Green 76
Time Gain Compensation(TGC)
• The purpose of TGC is to compensate fo...
Applications Training for Service - Jennifer Green 77
Dynamic Range(dB)
• Ratio of largest to smallest echo power.
• High ...
Applications Training for Service - Jennifer Green 78
Gray Scale Maps
• Apply nonlinear assignment of the display
brightne...
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  1. 1. Abdominal Anatomy Overview Jennifer Green General Imaging Training Manager
  2. 2. Applications Training for Service - Jennifer Green 2 • Scanning positions • Sonographic anatomy • System setup ABDOMEN
  3. 3. Applications Training for Service - Jennifer Green 3 Ultrasound Scan Planes • Sagittal • Transverse • Coronal
  4. 4. Applications Training for Service - Jennifer Green 4
  5. 5. Applications Training for Service - Jennifer Green 5
  6. 6. Applications Training for Service - Jennifer Green 6
  7. 7. Applications Training for Service - Jennifer Green 7 Ultrasound Terminology • Anterior • Medial • Superior • Supine • Oblique • Posterior • Lateral • Inferior • Prone • Decubitus
  8. 8. Applications Training for Service - Jennifer Green 8 Ultrasound Terminology • Hyper echoic • Echogenic • Homogeneous • Hypo echoic • Echo poor • Inhomogeneous
  9. 9. Applications Training for Service - Jennifer Green 9 Anatomy
  10. 10. Applications Training for Service - Jennifer Green 10 Anatomy • Liver • Gall Bladder (GB) • Common Bile Duct (CBD) • Pancreas • Kidneys • Bladder • Prostate • Uterus • Ovaries
  11. 11. Applications Training for Service - Jennifer Green 11 GREAT VESSELS • Aorta • Celiac Axis • SVC • Renal Arteries • Hepatic Artery • IVC • Renal veins • Portal vein • Hepatic Veins
  12. 12. Applications Training for Service - Jennifer Green 18 LIVER • Found in right upper quadrant (RUQ) • Largest internal organ • Stores and filters blood • Produces bile • Synthesizes many substances • Performs vast number of metabolic functions
  13. 13. Applications Training for Service - Jennifer Green 19 LIVER • During deep inspiration!!!, • Patient position – supine - left oblique - left lateral decubitus (LLD) • Sonographic windows: – Mid line, inferior to xiphoid process • Left lobe Sagittal and Transverse – Inferior & superior to right costal margin • Right lobe Sagittal and Transverse
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  22. 22. Applications Training for Service - Jennifer Green 34 GALL BLADDER(GB) • Found in RUQ • Contractile sack • Contains and concentrates bile • Best seen in LLD or upright position • Inspiration • Normal wall thickness 3mm
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  25. 25. Applications Training for Service - Jennifer Green 40 COMMON BILE DUCT (CBD) • Conducts bile from the G.B. to the duodenum • Found in RUQ, inferior to the G.B. • CBD runs anterior to the portal vein; distal part is lateral to the common hepatic artery • Best seen in LLD
  26. 26. Applications Training for Service - Jennifer Green 41
  27. 27. Applications Training for Service - Jennifer Green 42 PANCREAS • Found in upper mid abdomen; extends from the hilum of the spleen to the duodenum. • Posterior to the stomach,anterior to the big vessels. • Gland, produces hormones and digestive enzymes.
  28. 28. Applications Training for Service - Jennifer Green 43 PANCREAS • Best seen in supine position in inspiration or pushed up abdomen. • Sonographic appearance: – smooth borders; homogeneous, mid gray echoes – echogenicity  with age.
  29. 29. Applications Training for Service - Jennifer Green 44
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  31. 31. Applications Training for Service - Jennifer Green 46 KIDNEYS • Paired organ; 9 –13cms long • Principal parts: cortex, medulla, sinus... • Filters metabolic wastes from the blood. • Normal variants: – Dromedary humps – Double collecting system – Horseshoe – Ectopic kidney
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  36. 36. Applications Training for Service - Jennifer Green 56 BLADDER • It is a symmetrical, hollow, muscular organ. • Located posterior to the symphysis pubis. • Shape varies with distention. • Normal thickness of the distended wall is < 1cm. • Provides window for Ob/Gyn, prostate.
  37. 37. Applications Training for Service - Jennifer Green 57 BLADDER • Function: – Urine delivered through ureters, is stored in the bladder, and released through urethra. • Sonographic appearance: – Wall is a smooth echogenic line – cavity is not seen if collapsed, otherwise is non echoic.
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  40. 40. Applications Training for Service - Jennifer Green 60 PROSTATE • Lies inferior to the urinary bladder,and anterior to the rectum • The size of the gland 3.5x4x2.5 cm • The base is the broadest and it is in contact with bladder floor • The urethra and the ejaculatory ducts pass through the prostate • Best seen endo rectally (ER), size can be estimated trans abdominally (TA)
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  45. 45. Applications Training for Service - Jennifer Green 67 UTERUS • Pear shaped pelvic organ lying in midline. • Found in the small pelvis infero-posterior to the bladder • Usual size: 7-8x3-5x3-5 cm. • Uterus is divided into: cervix, corpus, fundus, cornua. • Has three layers : endometrium, myometrium, serous.
  46. 46. Applications Training for Service - Jennifer Green 68 UTERUS • Endometrial cavity is continuous with vagina via cervix. • Uterus can be retroverted/flexed or anteverted/flexed. • Best seen endo vaginally (EV), need full bladder for trans abdominal (TA) • Sonographic appearance: – myometrium is midgray with even texture – endometrium is a thin echogenic line that varies in intensity with menstrual phase and age.
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  49. 49. Applications Training for Service - Jennifer Green 71 OVARIES • Paired pelvic organ, position very variable alongside the uterus. • Search lateral/posterior to the uterus. • Best seen EV. • Normal post pubertal size approx: 4x3x2 cm • Sonographic appearance: – homogenous midgray echogenicity – follicles are round, anechoic, on the periphery.
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  52. 52. Applications Training for Service - Jennifer Green 74 Grey Scale • U/S is a dynamic examination needing frequent optimization of the imaging parameters for consistent good quality of images. • Sound pathway changes constantly due to movement of both the patient and the scanner. • Important parameters: power (MI) Gain TGC Dynamic Range (dB) Gray Maps.
  53. 53. Applications Training for Service - Jennifer Green 75 Power and Gain • Balance is needed to maintain safety (ALARA principle) and to obtain the good image quality through wider dynamic range. •  power, than  gain
  54. 54. Applications Training for Service - Jennifer Green 76 Time Gain Compensation(TGC) • The purpose of TGC is to compensate for attenuation along the propagation path. • The desired effect is to equalize near to far field brightness.
  55. 55. Applications Training for Service - Jennifer Green 77 Dynamic Range(dB) • Ratio of largest to smallest echo power. • High dynamic range image has low contrast due to numerous available shades of gray, giving high tissue differentiation – good for easy patients, superficial structures • Images of lower dynamic range show increased contrast. Reduced number of available shades of gray will poorly differentiate tissues – good for challenging patients.
  56. 56. Applications Training for Service - Jennifer Green 78 Gray Scale Maps • Apply nonlinear assignment of the display brightness range among stored range of the system. • Manipulation enables emphasis of certain image elements over each other.

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